Jessica L Miller Counseling

Mental Health Counselor, Bellevue, WA

First Visit Forms

Hello and Welcome! Visiting this page means you have likely contacted JLM Counseling Services and scheduled an initial appointment for therapy. Please read through the following pieces of necessary information. If you have any questions, please feel free to contact me and I am looking forward to meeting you soon.


Please respond to the confirmation email to confirm and lock in your appointment time. If I do not hear from you within 24 hours of sending the email, I will assume you have found alternative options for therapy.


Please download, fill out and bring the following four forms to your initial visit. If you are unable do this prior to your visit, please let me know and I will have them available for you in my waiting room when you arrive. Please arrive about 20 minutes prior to our scheduled time to allow time for you to fill out the forms.

  1. Disclosure Statement
  2. Emergency Information
  3. Intake Information
  4. Privacy Practices